Provider Demographics
NPI:1053670331
Name:CARSWELL, CLEMENTINA (RN)
Entity Type:Individual
Prefix:
First Name:CLEMENTINA
Middle Name:
Last Name:CARSWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 PLUNKETT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-5763
Mailing Address - Country:US
Mailing Address - Phone:954-929-4071
Mailing Address - Fax:
Practice Address - Street 1:2634 PLUNKETT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-5763
Practice Address - Country:US
Practice Address - Phone:954-929-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN-1556392163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse